Provider Demographics
NPI:1578446209
Name:AKALU, HABTAMU ENGIDAW
Entity type:Individual
Prefix:
First Name:HABTAMU
Middle Name:ENGIDAW
Last Name:AKALU
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:921 S CLEARWATER HILLS ST
Mailing Address - Street 2:
Mailing Address - City:OLATHE
Mailing Address - State:KS
Mailing Address - Zip Code:66061-5263
Mailing Address - Country:US
Mailing Address - Phone:913-267-9866
Mailing Address - Fax:
Practice Address - Street 1:921 S CLEARWATER HILLS ST
Practice Address - Street 2:
Practice Address - City:OLATHE
Practice Address - State:KS
Practice Address - Zip Code:66061-5263
Practice Address - Country:US
Practice Address - Phone:913-267-9866
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-07-29
Last Update Date:2025-07-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes172A00000XOther Service ProvidersDriver